Julia Simon: "STPs and ACOs: solutions for a 'bankrupt' NHS and social care system"?

Talk given at the Learie Constantine centre, Dudden Hill Lane, on 1st December 2016 at the invitation of Brent Patient Voice to an audience of 50 people.

Dr Julia Simon was until Sept 2016 the head of NHS England's commissioning policy unit and its programme director of co-commissioning of primary care.

She had worked at London and national NHS level since 2012 on CCG and commissioning issues.

 

Dr Simon referred to a small number of presentation slides.

"There has been a split between commissioning and provision for over 25 years. The 2012 Health and Social Care Act aims to create a truly clinically led system with GPs in the driving seat. But the outcome is actually a fragmented commissioning system with three main budget holders across CCGs, NHSE and local authorities (public health), and a bewildering number of other national organisations.

In my view healthcare isn't a market: hospitals do not fail. They are always bailed out in order to give citizens care - which seems obvious. Andrew Lansley, the Secretary of State for Health responsible for the introduction of the HSCS Act, is married to a GP.

CCGs:

There were 212 in 2012 and there are 209 now. They are legally constituted by their members and all practising GPs must be members of one. CCGs have a statutory duty to (1) improve primary care and (2) to engage citizens.

Fragmentation:

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Ambulance target failures highlight NHS crisis, say health chiefs

NHS England says figures showing only one of UK’s 13 services met eight- minute target is a system-wide problem.

The figures showed that ambulance crews are wasting more than 500,000 hours queuing outside hospitals.

 

Figures showing that every ambulance service in England failed to meet response time targets for the past 16 months are a sign of a system-wide problem, NHS England has admitted.

The figures, released under freedom of information rules, showed that of the UK’s 13 ambulance services, only Wales was reaching emergencies within the target time of eight minutes. They also showed that the number of patients waiting for ambulances for more than an hour had almost tripled in the past two years, and that ambulance crews were wasting more than 500,000 hours queuing outside hospitals.

Health unions and the Labour party seized on the figures as an illustration that funding was failing to keep pace with unprecedented demand.

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Staffordshire £1.2bn cancer contract given green light

  • 26 November 2016
  • From the section Stoke & Staffordshire   - BBC News

A £1.2bn plan to outsource cancer and end-of-life care in Staffordshire has been given the go-ahead by NHS England.

The project, which has attracted considerable opposition, was put on hold in January after a similar contract in Cambridge was scrapped due to financial concerns.

The 10-year contract in Staffordshire is expected to be up and running by April. Bidders are believed to include private companies Virgin Healthcare and Interserve.

The deal includes a £690m contract to run cancer care across four Staffordshire clinical commissioning groups (CCGs) - Stafford and Surrounds, Cannock Chase, Stoke-on-Trent and North Staffordshire. The successful bidder will be asked to co-ordinate cancer care throughout the county - from diagnosis through to treatment and end-of-life care. The CCGs have previously said the aim was to streamline services and "provide the best cancer and end-of-life care for patients".

However, Labour MP for Stoke-on-Trent South, Rob Flello, described it as an unpopular and dangerous project that could see a private provider take over NHS care.

In July 2015 a Staffordshire NHS Trust, thought to be University Hospitals North Midlands NHS Trust, pulled out of a complex partnership to bid for this contract.

NHS to use private firms to beat the winter crisis

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